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BCNU, velban, cyclophosphamide, procarbazine, and prednisone (BVCPP) in advanced Hodgkin's disease
Author(s) -
Durant John R.,
Gams Richard A.,
VelezGarcia Enrique,
Bartolucci Alfred,
Wirtschafter David,
Dorfman Ronald
Publication year - 1978
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197811)42:5<2101::aid-cncr2820420504>3.0.co;2-m
Subject(s) - medicine , procarbazine , prednisone , nodular sclerosis , cyclophosphamide , maintenance therapy , chemotherapy , multivariate analysis , vincristine , disease , lymphocyte , gastroenterology , surgery , oncology , lymphoma , hodgkin lymphoma
Three hundred twenty‐four evaluable patients with advanced or recurrent Hodgkin's disease were treated with BVCPP. After stratification according to amount of prior therapy, patients who achieved complete remission were randomized to no additional therapy, 6 monthly cycles of MOPP or 6 additional monthly cycles of BVCPP. Complete remission rates were comparable to other studies: 68–73% for those who had not received prior chemotherapy and 28% for those who had. Although curves of disease‐free survival suggested that BVCPP maintenance therapy significantly prolonged a complete remission in previously untreated patients, multivariate analysis did not demonstrate such therapy to be a significant prognostic factor. Rather, favorable prognostic indicators were shown to be related to host factors. Subsequent analysis demonstrated that the maintenance and no‐maintenance groups of previously untreated patients were not strictly comparable in that the maintained group had more patients with favorable histologies who were less than 40 years of age. Herpes Varicella Zoster was not found to affect prognosis adversely. It is concluded that maintenance chemotherapy with BVCPP or MOPP does not significantly improve duration of complete remission or survival and that further comparative or sequential studies should include stratification of the important factors influencing duration of response and survival. Further, even though second remissions may be induced in the previously treated, their subsequent prognosis is poorer. For all patient groups female sex and an initial lymphocyte count > 1,372 were favorable factors. For those with little or no prior therapy, age <40, Caucasian race, and having lymphocyte predominance or nodular sclerosis favorably influenced the outcome as well. For those with major prior therapy not having had prior chemotherapy, having IIIA disease, and not having nodular sclerosis were important additional determinants of remission or survival. Cancer 42:2101–2110, 1978.